CS000000-A | 11/13/23

Center for Disease Control and Prevention 

Immunization Services Division, Insights Unit

The findings and conclusions in this report are those 

of the author(s) and do not necessarily represent 

the official position of the Centers for Disease 

Control and Prevention (CDC).

CDC’s State of 

Vaccine Confidence 

Insights Report

Respiratory Viruses Special Report: 

COVID-19, RSV, and Flu 

November 13, 2023

Date Range: August 1 – August 31, 2023
Page: 2

State of Vaccine Confidence Insights Report | November 13, 2023

Report Summary

Themes with the potential to impact vaccine confidence and demand:

 Theme 1: Public health officials are urging eligible individuals to get vaccinated against 

COVID-19, RSV, and flu and to immunize infants using monoclonal antibody.

 Theme 2: Consumers are becoming less concerned with COVID-19. Some social media users are 

reluctant to receive the updated COVID-19 booster for the 2023-2024 season.

 Theme 3: Consumers and social media users are discussing the recently FDA-approved RSV 

vaccines for pregnant individuals and adults 60 years of age and older. 

 Theme 4: Consumers are concerned about side effects from flu vaccines. Additionally, social 

media users are discussing egg proteins present in flu vaccines.

Ways public health partners can take action to improve confidence in COVID-19, RSV, and flu 

vaccines:

 Promote vaccination for COVID-19, RSV, and flu, especially among people who are at high risk for 

COVID-19, RSV, and flu, such as older adults, young children, pregnant people, and individuals 

with underlying health conditions.

 Facilitate accessibility of vaccines and preventative antibodies to all communities, including 

populations that are medically underserved who may face barriers to healthcare access.

 Offer vaccines at convenient and accessible locations, such as clinics, pharmacies, workplaces, 

schools, and community centers. Provide flexible hours for vaccination clinics to accommodate 

various schedules and enable walk-in appointments to reduce barriers.

 Launch public awareness campaigns to educate the community about the risks associated with 

these viruses and the importance of vaccination, mask-wearing, and good hygiene practices.

 Acknowledge pandemic fatigue and empathize with people’s concerns and frustrations. 

Reinforce the message that vaccination is a vital step toward decreasing risk of serious 

respiratory illness.

 Maintain surveillance systems to monitor the prevalence and spread of flu and RSV alongside 

COVID-19. This data can inform targeted interventions to increase vaccine uptake and vaccine 

confidence.

 Maintain transparent reporting of respiratory virus surveillance and vaccine effectiveness to 

keep the public informed and engaged in the mitigation efforts.

Resources: The following link contains graphics and assets partners can use to address the themes in 

this report: https://centersfordiseasecontrol.sharefile.com/d-s3c8384e7f7eb413d92ae7b9731aaae13
Page: 3

State of Vaccine Confidence Insights Report | November 13, 2023

Contents

4

Aims and Methods

5

Public health officials are urging eligible 

individuals to get vaccinated against COVID-19, 

RSV, and flu and to immunize infants with 

monoclonal antibody.

5

Public Perceptions, Concerns, and Threats to 

Vaccine Confidence

5

Commonly Asked Questions and Queries from 

the Public

6

Inaccurate Health Information Themes

6

Consumers are becoming less concerned with 

COVID-19. Some social media users are reluctant 

to receive the 2023-2024 updated COVID-19 

booster for the 2023-2024 season.

6

Public Perceptions, Concerns, and Threats to 

Vaccine Confidence

8

Commonly Asked Questions and Queries from 

the Public

8

Inaccurate Health Information Themes

9

Consumers and social media users are discussing 

the recently FDA-approved RSV vaccines for 

pregnant individuals and adults over 60 years of 

age.

9

Public Perceptions, Concerns, and Threats to 

Vaccine Confidence

10

Common Questions and Queries form the Public

11

Inaccurate Health Information Themes

12

Consumers are concerned about side effects from 

flu vaccines. Additionally, social media users are 

discussing egg proteins present in flu vaccines.

12

Public Perceptions, Concerns, and Threats to 

Vaccine Confidence

12

Common Questions and Queries form the Public

13

Inaccurate Health Information Themes

14

Ways public health partners can take action to 

improve confidence in RSV, flu, and COVID-19 

vaccines

15

References
Page: 4

State of Vaccine Confidence Insights Report | November 13, 2023

Aims and Methods

By rapidly reviewing and analyzing numerous specific sources and inputs, this State of Vaccine 

Confidence Insights Report emphasizes major themes influencing RSV, COVID-19, and flu vaccine 

confidence and uptake among adults. In addition, by examining how consumers think and feel, social 

processes, and the practical issues around vaccination, this Insights Report seeks to identify emerging 

issues related to the spread of inaccurate health information to help identify where intervention 

efforts can improve vaccine confidence. Data for this report was specially gathered during the 

beginning of the fall and winter respiratory virus season to help analyze vaccine confidence themes 

among adults.

The information in this report is only a snapshot, and specific populations may be underrepresented. 

Images and quotes are illustrative examples and are not meant to comprehensively cover all content 

related to the highlighted themes. 

How do you classify this theme/information? 

High risk Moderate risk Low risk Positive sentiment

 May lead to 

vaccine refusals 

and decreased 

uptake 

 Wide reach, 

pervasive  

 Potential to 

trigger hesitancy 

to vaccination

 Moderate 

reach, modest 

dissemination 

 Concerning, but 

low risk to vaccine 

confidence 

 Limited 

reach, limited 

dissemination 

 Could increase 

vaccine 

confidence, intent, 

or motivation

 Variable reach and 

dissemination

How has this theme/idea changed over time (since last report or over the course of multiple 

reports)? 

Increasing

Information spreading 

rapidly 

Stable

Information remaining 

constant at prior level 

Decreasing

Information is not gaining further traction 

and there has been no indication of additional 

activity 
Page: 5

State of Vaccine Confidence Insights Report | November 13, 2023

Public health officials are urging eligible individuals 

to get vaccinated against COVID-19, RSV, and flu and 

to immunize infants using monoclonal antibody. 

Along with seasonal influenza virus (flu) and respiratory syncytial virus (RSV), SARS-CoV-2 has become 

a part of the respiratory virus season.1 These respiratory viruses could pose a formidable challenge to 

public health and healthcare systems nationwide this fall/winter season. Experts emphasize the urgent 

need for preventive measures, such as vaccination, mask-wearing, and good hygiene to decrease 

the spread of disease. Vaccines are available to protect against COVID-19, RSV, and flu. For infants, 

passive immunization for RSV with preventive antibodies is available. Recommendations for each 

vaccine differ, but they are all available for the most vulnerable populations.

Public Perceptions, Concerns, and Threats to Vaccine Confidence 

 According to the C.S. Mott Children’s Hospital National Poll on Children’s Health published in 

August 2023, fewer parents ranked vaccine safety (18%) and COVID-19 (12%) as a “big problem” 

compared with other child health concerns, such as screen time and depression/suicide.2

 Sterling Ransone, board chair of the American Academy of Family Physicians, named “cost” as the 

top barrier for parents to seek routine childhood immunization for their children.3

 Prominent public health figures have published news articles and posted on social media to 

urge consumers to receive vaccines for 

COVID-19, RSV, and flu, if eligible.4,5,6

 Some social media users, including 

some physicians, are promoting “natural” 

remedies, such as elderberry, as safe and 

effective alternatives to vaccination.7,8,9

Commonly Asked Questions and 

Queries from the Public 

 Why should individuals be concerned about 

respiratory virus season?

 It is common to get sick from respiratory illnesses such as COVID-19, flu, and respiratory 

syncytial virus (RSV), especially in the fall and winter. There are actions you can take to protect 

yourself and others from respiratory infections, such as vaccination, handwashing, cleaning, 

masks, masking, physical distancing, testing, and air quality improvements.10

 Can COVID-19, RSV, and flu vaccines be co-administered?11,12

 Administration of RSV vaccine on the same day with other needed vaccines is acceptable. 

However, according to results of coadministration studies of RSV vaccines with influenza 

vaccines, common side effects such as fever and soreness at the injection site may be 

increased when these two vaccines are administered at the same healthcare visit. Some 

studies also suggest it’s possible that the immune response to flu vaccine may not be as strong 

if given on the same day with RSV vaccine, but the clinical significance of this is unknown. 

Additional research is ongoing to inform guidance on coadministration of RSV vaccine and 

other adult vaccines, including COVID-19 vaccine.13
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State of Vaccine Confidence Insights Report | November 13, 2023

 Flu vaccines and COVID-19 vaccines can be given at the same visit if you are due for both 

vaccines.14

Inaccurate Health Information Themes 

 Some social media users believe a likely circulation of SARS-CoV-2, RSV, and influenza virus 

at the same time is not real and that pharmaceutical companies created the idea to sell more 

vaccines.15,16,17

Consumers are becoming less concerned with 

COVID-19. Some social media users are reluctant to 

receive the 2023-2024 updated COVID-19 booster for the 

2023-2024 season. 

After experiencing COVID-19 vaccination campaigns for the original vaccine series, original vaccine 

booster(s), and the bivalent vaccine, along with the continued identification of many SARS-CoV-2 

variants, some individuals are experiencing a sense of weariness and hesitation to get an updated 

2023-24 COVID-19 vaccine. This hesitancy, compounded by fears of possible vaccine side effects and 

beliefs of vaccine ineffectiveness, underscores the complex task of achieving high vaccine uptake for 

the updated COVID-19 vaccine available for the 2023-2024 season. 

Public Perceptions, Concerns, and Threats to Vaccine Confidence 

 In a Yahoo-YouGov news survey of 1,665 adults from August 17 to August 21, 31% of 

respondents were worried about COVID-19, while 69% were not worried, including 35% of 

respondents who said they were not worried at all.18

 Additionally, 63% of respondents reported they do not follow the number of COVID-19 cases 

very closely or at all, compared to 33% of respondents who follow the number of COVID-19 

cases very or somewhat closely.

 Thirty-four percent of surveyed adults reported previously receiving COVID-19 booster doses 

and are willing to receive another one, while 9% had previously received boosters but would 

not be willing to receive another COVID-19 vaccine dose. Fifty-seven percent of respondents 

who had received a primary series reported they had not received any COVID-19 booster 

dose.18

 Of respondents ages 65 years and older, 50% said they were keeping up with reports noting 

COVID-19 levels and 57% of respondents reported they would receive an updated 2023-24 

COVID-19 vaccination.18

 The August 2023 KFF Health Misinformation Tracking Poll Pilot showed that many adults in the 

United States have heard misinformation about COVID-19 and vaccines.19

 Sixty-five percent of adults have heard or read the false claim that COVID-19 vaccines have 

caused thousands of sudden deaths in otherwise healthy people. Thirty-four percent of 

respondents say the false claim is definitely or probably true, and 29% have both heard or read 

this false claim and say it is definitely or probably true.19
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State of Vaccine Confidence Insights Report | November 13, 2023

 52% of adults have heard or read 

the false claim that COVID-19 

vaccines have been proven to 

cause infertility. Twenty-seven 

percent of respondents say the 

false claim is definitely or probably 

true, and 19% have both heard or 

read this false claim and say it is 

definitely or probably true.19

 41% of adults have heard or read 

the false claim that more people 

have died from COVID-19 vaccines 

than have died from COVID-19. Twenty percent of respondents say the false claim is definitely 

or probably true, and 14% have both heard or read this false claim and say it is definitely or 

probably true.19

 Some social media users are concerned the SARS-CoV-2 sub lineage BA.2.86 variant is more 

capable of causing infection in people who have previously had COVID-19 or who have received 

COVID-19 vaccines.20,21,22,23

 This may be a response to the phrase, “BA.2.86 may be more capable of causing infection 

in people who have previously had COVID-19 or who have received COVID-19 vaccines” in 

CDC’s Risk Assessment Summary for SARS-CoV-2 Sublineage BA.2.86 webpage. Although not 

clear from the website language, the phrase is meant to convey that those who have been 

vaccinated or previously infected may be more susceptible to that variant than they were to 

prior variants.

24

 In response to the updated COVID-19 vaccine for the 2023-2024 season, some social media users 

are expressing weariness about the ongoing need for updated COVID-19 vaccines.25,26

 Some social media users are stating they will refuse the 2023-2024 updated COVID-19 vaccine 

and have refused all COVID-19 vaccines thus far, touting their status as “purebloods.”27,28,29

 Some social media users are sharing skepticism and anecdotes of adverse events they believed 

were triggered by COVID-19 vaccines.30,31,32

 As the 2023-2024 school year begins, social 

media users are sharing their concern 

regarding vaccinating children against 

COVID-19. Users claim COVID-19 vaccines 

are not necessary nor effective and are 

concerned about harmful side effects, such 

as myocarditis and blood clots.33,34,35

 Cases of myocarditis and pericarditis have rarely been observed following receipt of COVID-19 

vaccines used in the United States. Evidence from multiple monitoring systems in the United 

States and around the globe support a causal association between some mRNA COVID-19 

vaccines (i.e. made by Moderna or Pfizer-BioNTech) and myocarditis and pericarditis with the 

highest risk among males age 12-39 years.36

 Social media users are concerned there will be a nationwide mandate for the 2023-2024 updated 

COVID-19 vaccine. Many are stating they will not comply with any vaccine mandates.37,38,39,40
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State of Vaccine Confidence Insights Report | November 13, 2023

Commonly Asked Questions and Queries from the Public

 Will the updated COVID-19 vaccine for the 2023-2024 season be free?

 CDC’s Bridge Access Program provides no-cost COVID-19 vaccines to adults without health 

insurance and adults whose insurance does not cover all COVID-19 vaccine costs. No-cost 

COVID-19 vaccines through this program will be available until December 31, 2024.41

 You can get no-cost COVID-19 vaccines at healthcare providers, federally supported health 

centers, and retail pharmacy chains participating in the Bridge Access Program. Visit vaccines.

gov to find providers that offer no-cost COVID-19 vaccines through the Bridge Access Program. 

Providers participating in the Bridge Access Program are contractually obligated to add 

vaccine availability to vaccines.gov. We expect reported availability to increase in the coming 

days.41

 Where can I find COVID-19 vaccines?

 Use Vaccines.gov to find a nearby location, including vaccine options for children and adults. 

Contact information for vaccination locations is provided on the website.42

 Why do individuals need to receive the 2023-2024 updated COVID-19 vaccine if they’ve already 

received previous booster doses?

 The virus that causes COVID-19 is always changing, and protection from both COVID-19 

vaccines and from natural infection decline over time. Receiving an updated 2023-24 

COVID-19 vaccine can provide better protection against the variants currently responsible for 

most infections and hospitalizations in the United States.43 The updated COVID-19 vaccines 

have been updated to include a monovalent (single) component that corresponds to the 

Omicron variant XBB.1.5.44

 Who is eligible for the 2023-2024 updated COVID-19 vaccine for the fall 2023-2024 season?

 CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect 

against the potentially serious outcomes of COVID-19 illness this fall and winter. Updated 

COVID-19 vaccines from Moderna, Novavax, and Pfizer-BioNTech are now available.43

Inaccurate Health Information Themes 

 Some social media users claim receiving multiple COVID-19 booster doses is ineffective and 

overall harmful.45,46,47

 Using the hashtag #diedsuddenly, some social media users believe COVID-19 vaccines can cause 

death.48,49,50

 The erroneous belief that vaccinated individuals are causing the new COVID-19 variants is 

circulating on social media.51

 Some social media users believe COVID-19 vaccines are not safe for children because they have 

not finished clinical trials. Additional social media users believe future COVID-19 vaccines are not 

safe because the Food and Drug Administration (FDA), the agency that authorizes or approves 

vaccines, considers the 2023-2024 vaccine update to be a minor change that does not require 

new clinical trials.52,53,54

 Some social media users believe vaccinated individuals are more likely to get COVID-19 than 

unvaccinated individuals.20,21,22,23

 Some social media users believe there is an 2023-2024 updated COVID-19 vaccine because 

previous formulas for COVD-19 vaccines were ineffective.55,56,57
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State of Vaccine Confidence Insights Report | November 13, 2023

Consumers and social media users are discussing the 

recently FDA-approved RSV vaccines for pregnant 

individuals and adults over 60 years of age.

In May 2023, two RSV vaccines—GSK’s Arexvy and Pfizer’s Abrysvo (RSVpreF)—received FDA approval 

for individuals aged 60 years and older for prevention of RSV lower respiratory tract disease (LRTD). 

In August 2023, the U.S. Food and Drug Administration approved Abrysvo as the first vaccine for use 

in pregnant individuals to prevent LRTD and severe LRTD caused by respiratory syncytial virus (RSV) 

in infants from birth through 6 months of age. Abrysvo is approved for use at 32 through 36 weeks 

gestational age of pregnancy and should be administered seasonally.58,59

Public Perceptions, Concerns, and Threats to Vaccine Confidence 

 Results of a CDC and University of Iowa/RAND survey on RSV immunizations to prevent RSV 

disease in infants showed a third of respondents thought their infant would “definitely or 

probably” be infected with RSV within a year, while 70% reported they “definitely or probably” 

would get an RSV antibody injection 

for their baby if safe and effective.60

 Some consumers are confused 

about the difference between RSV 

preventative monoclonal antibodies 

and RSV vaccines.61,62,63

 According to data from the National 

Poll on Healthy Aging, about half 

(52%) of adults from 60 to 80 years 

of age have heard about the new 

RSV vaccines.64

 Additionally, 21% of these respondents reported they were very interested in RSV vaccines, 

while 43% said they were somewhat interested.64

 Only 41% of respondents who classified their health as fair or poor had heard of RSV vaccines, 

compared to 53% of adults who rated their health as good to excellent. 

 More than 65% of respondents with a chronic health condition said they were very or 

somewhat interested in receiving an RSV vaccine, regardless of whether they had previously 

heard of the vaccines prior to the poll.64

 Some social media users are concerned RSV vaccination during pregnancy will cause adverse 

events such as birth defects, stillbirths, and premature birth.65,66 This might be related to concern 

expressed by the Vaccines and Related Biological Products Advisory Committee (VRBPAC) and 

the Advisory Committee on Immunization Practices (ACIP) over premature births linked to RSV 

vaccination in clinical trials.67,68

 Individuals on social media are posting their distrust of pharmaceutical companies following 

FDA approval of RSV vaccines for both older populations and pregnant people.69,70 Consumers 

perceiving vaccines as a way to increase profits for pharmaceutical companies, instead of a vital 

preventive health measure, may decrease vaccine confidence and hinder RSV vaccine uptake. 
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State of Vaccine Confidence Insights Report | November 13, 2023

 Individuals are using social media to share their negative experiences and opinions from the 

COVID-19 pandemic, dissuading others from receiving RSV vaccines.71,72,73

 Some public health figures are concerned about the cost of RSV vaccines.74

Commonly Asked Questions and Queries from the Public

 How much will RSV vaccines cost consumers?75

 The Inflation Reduction Act of 2022 states that vaccines covered under Medicare prescription 

drug plans (Part D) and Medicaid are free in 2023, meaning there are no co-payments or 

deductibles for individuals for any vaccines 

recommended by ACIP.76 RSV vaccines are 

covered under Medicare Part D. 

 Medicare enrollees without a Part D plan 

may have to pay for the RSV vaccine out of 

pocket.77

 Older adults without health insurance 

coverage may experience financial hardship 

obtaining an RSV vaccine.78

 State Medicaid agencies must cover approved adult ACIP-recommended vaccinations, 

including those not found on the adult immunization schedule or considered routine, without 

cost-sharing for most beneficiaries. For adults in the Affordable Care Act (ACA) adult group 

who receive all essential health benefits (EHB), states must cover all ACIP-recommended 

vaccinations found on the CDC/ACIP adult immunization schedule, without cost-sharing.79

 Is the RSV vaccine an mRNA vaccine?80

 Both vaccines are recombinant protein vaccines that cause the immune system to produce 

RSV antibodies. Both are currently approved as a single dose and were shown in clinical trials 

protect against symptomatic lower respiratory tract disease caused by RSV in adults ages 60 

and older, with more than 80% percent efficacy in the first RSV season after vaccination. GSK’s 

vaccine includes an adjuvant (the same adjuvant used in GSK’s recombinant zoster vaccine 

[Shingrix]), which is a component that is intended to enhance the immune response to 

vaccination. Pfizer’s vaccine does not contain an adjuvant.81,82

 Who should get the RSV vaccine?

 People who are 32 through 36 weeks pregnant during September through January should 

get one dose of maternal RSV vaccine to protect their babies. RSV season can vary around the 

country. If you live in Alaska, Florida, or outside the continental U.S., talk to your healthcare 

provider about when RSV season is expected where you live.83

 CDC recommends that adults 60 years of age and older may receive a single dose of RSV 

vaccine using shared clinical decision-making (SCDM). This means that the decision to 

vaccinate a patient should be based on a discussion between the health care provider and 

the patient, which might be guided by the patient’s risk for disease and their characteristics, 

values, and preferences; the provider’s clinical discretion; and the characteristics of the 

vaccine.84,85

 How can parents protect infants against RSV?

 There are two RSV antibody products that can help prevent severe RSV disease in infants and 

young children: Nirsevimab (Beyfortus), and Palivizumab (Synagis).86
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State of Vaccine Confidence Insights Report | November 13, 2023

 Nirsevimab is recommended for all infants younger than 8 months of age born during RSV 

season or entering their first RSV season. Except in rare circumstances, most infants younger 

than 8 months of age do not need nirsevimab if they were born 14 or more days after 

their mother got RSV vaccine. Nirsevimab is also recommended for Some children aged 

8 through 19 months who are at increased risk for severe RSV disease and entering their 

second RSV season.86

 Palivizumab (Synagis) use is limited to some children younger than age 24 months of age 

with certain conditions that place them at increased risk for severe RSV disease. It must be 

given once a month during RSV season.86

 If nirsevimab is not available, high-risk infants who are recommended to receive palivizumab 

in the first or second year of life should receive palivizumab, as previously recommended, until 

nirsevimab becomes available.87

 What are the side effects of the RSV vaccine?

 Pain, redness, and swelling where the shot is given, fatigue (feeling tired), fever, headache, 

nausea, diarrhea, and muscle or joint pain can happen after RSV vaccination.88

 Serious neurologic conditions, including Guillain-Barré syndrome (GBS), have been reported 

after RSV vaccination in clinical trials of older adults. Due to the small number of events, it is 

unclear whether these events occurred due to chance, or whether RSV vaccination increases 

the risk of these events.84,88

 In clinical trials of older adults, atrial fibrillation was reported in a higher number of 

participants who received RSV vaccination than in those who received placebo. Due to the 

small number of events, it is unclear whether these events occurred due to chance, or whether 

RSV vaccination increases the risk of these events.84

 Preterm birth and high blood pressure during pregnancy, including pre-eclampsia, have been 

reported among pregnant people who received RSV vaccine during clinical trials. It is unclear 

whether these events were caused by the vaccine.88

Inaccurate Health Information Themes

 Some social media users believe RSV vaccines were created to depopulate the planet.89,90

 RSV vaccines had to be developed only because widespread COVID-19 vaccination created 

RSV.91,92,93

 Some social media users believe RSV vaccines are not safe for pregnant individuals and their 

developing fetuses.94,95,96

 Some social media users believe RSV vaccine did not undergo adequate testing and clinical trials 

before FDA approval.97,98,99

 Some social media users believe RSV vaccine may cause death.100,101,102
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State of Vaccine Confidence Insights Report | November 13, 2023

Consumers are concerned about side effects from flu 

vaccines. Additionally, social media users are 

discussing egg proteins present in flu vaccines. 

Although some consumers have made it a habit to receive annual influenza vaccine, some are 

expressing reluctance. Some social media users are concerned about potential side effects of flu 

vaccination and the presence of egg proteins in some flu vaccines. This apprehension can result 

in decreased vaccine confidence and uptake. Public health experts continually emphasize the 

importance of annual flu vaccinations, assuring the public of the vaccines’ safety and effectiveness in 

preventing serious illness and hospitalization associated with influenza. Additionally, ongoing research 

has led to the development of egg-free vaccine alternatives, although for all influenza vaccines, egg 

allergy is not a contraindication to influenza vaccination.103

Public Perceptions, Concerns, and Threats to Vaccine Confidence 

 Some consumers and social media 

users are concerned about egg proteins 

present in influenza vaccines,12,104

including vegans who are using social 

media to share that flu vaccines are not 

plant-based.105,106 However, the updated 

ACIP recommendations, as well as many 

news articles and social media users, are 

assuring the public it is safe for individuals with egg allergies to receive flu vaccines, without 

taking any additional safety measures beyond those recommended for all vaccines.107,108,109 These 

online discussions may be in response to updated CDC guidance regarding flu vaccine and 

people with egg allergies.

 The FDA and some social media users are urging individuals to receive an influenza vaccine 

given that influenza viruses can change from year to year and protection from vaccination wanes 

over time.110,111,112 ACIP recommends routine annual influenza vaccination for all persons aged 6 

month or older who do not have contraindications.103

 Some social media users are sharing their belief that it is not worthwhile to receive flu vaccine 

because it is still possible to get flu.113

 Some social media users are concerned receiving a flu vaccine will result in a worse case of flu 

than they would have had if they not been vaccinated.114,115,116

 Individuals are using social media to share adverse events caused by flu vaccines.117,118

Commonly Asked Questions and Queries from the Public

 Can individuals with egg allergies receive the flu vaccine?

 Everyone who is 6 months and older should receive an annual flu vaccine, including 

persons with egg allergy. Any flu vaccine (egg-based or non-egg-based) that is otherwise 

appropriate for the recipient’s age and health status can be used. Vaccinating a person with 

egg allergy does not require any additional safety measures for flu vaccination beyond those 

recommended for any vaccination, regardless of severity of previous reaction to egg.119

 Severe and life-threatening reactions to vaccines are rare but can occur with any vaccine and 
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State of Vaccine Confidence Insights Report | November 13, 2023

in any vaccine recipient, regardless of allergy history. All vaccines should be administered in 

settings in which personnel and equipment needed for rapid recognition and treatment of 

acute hypersensitivity reactions are available.119

 When will flu vaccines be available?120

 Influenza vaccine distribution has begun for the 2023-2024 influenza season. People should 

consult CDC’s guidance on the best timing for getting their flu vaccine.121

 Where can individuals find flu vaccines?

 Individuals can go to Vaccines.gov and 

select “Find Flu Vaccines.”42

 What are side effects of flu vaccines?

 Like any medical product, vaccines can 

cause side effects. Side effects of flu 

vaccine are generally mild and go away 

on their own within a few days.122

 Common side effects from a flu shot 

include soreness, redness, and/or swelling 

from the shot, headache, fever, nausea, 

and muscle aches, and can occasionally 

include fainting.122

 Some studies have found a possible small association of injectable flu vaccine with GuillainBarré syndrome (GBS). Overall, these studies estimated the risk for GBS after vaccination as 

fewer than 1 or 2 cases of GBS per one million people vaccinated. Other studies have not 

found any association. GBS is more common following flu illness than following flu vaccination 

although both occurrences are rare. GBS has not been associated with the nasal spray 

vaccine.122

 Is it possible to get the flu from flu vaccines?

 No, flu vaccines cannot cause flu. The vaccines either contain inactivated virus, meaning the 

viruses are no longer infectious, or a particle designed to look like a flu virus to your immune 

system. While the nasal spray flu vaccine does contain a live virus, the viruses are changed so 

that they cannot give you flu.122

Inaccurate Health Information Themes

 Some social media users believe receiving flu vaccine can cause or increase chances of 

flu.123,124,125,126,127

 Some social media users believe flu vaccines are only recommended to increase profits for 

pharmaceutical companies.128,129

 Some social media users believe flu vaccines are ineffective for children and older 

populations.130,131
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State of Vaccine Confidence Insights Report | November 13, 2023

Ways public health partners can take action to improve confidence in 

COVID-19, RSV, and flu vaccines

 Promote vaccination for COVID-19 among persons 6 months and older, seasonal flu among 

persons 6 months and older, and RSV for pregnant women and, based on shared clinical decision 

making, for adults 60 years and older. Promote immunization with monoclonal antibody for 

infants. 

 Promote vaccines and other preventive immunizations, especially for those at highest risk of 

severe illness, such as the elderly, infants and young children, pregnant people, and individuals 

with underlying health conditions.

 Facilitate accessibility of vaccines and preventative antibodies to all communities, including 

populations that are medically underserved who may face barriers to healthcare access.

 Offer vaccines at convenient and accessible locations, such as clinics, pharmacies, workplaces, 

schools, and community centers. Provide flexible hours for vaccination clinics to accommodate 

various schedules and enable walk-in appointments to reduce barriers.

 Launch public awareness campaigns to educate the community about the risks associated with 

these viruses and the importance of vaccination, mask-wearing, and good hygiene practices.

 Acknowledge pandemic fatigue and empathize with people’s concerns and frustrations. 

Reinforce the message that vaccination is a vital step toward decreasing risk of serious 

respiratory illness.

 Maintain surveillance systems to monitor the prevalence and spread of flu and RSV alongside 

COVID-19. This data can inform targeted interventions to increase vaccine uptake and vaccine 

confidence.

 Maintain transparent reporting of respiratory virus surveillance and vaccine effectiveness to 

keep the public informed and engaged in the mitigation efforts.
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State of Vaccine Confidence Insights Report | November 13, 2023

References 

Note: Omitted numbers are social media citations, which can be found in this online document. 

1. Centers for Disease Control and Prevention. (2023, September 29). What’s New: 2023-2024 Flu Season 

Outlook. https://www.cdc.gov/respiratory-viruses/whats-new/2023-2024-season-outlook.html

2. C.S. Mott Children’s Hospital National Poll on Children’s Health. (2023, August 21). Overuse of Devices 

and Social Media Top Parent Concerns. https://mottpoll.org/reports/overuse-devices-andsocial-media-top-parent-concerns

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